Can I Use Statins While I’m Pregnant?

Medically reviewed by Steven Kim, MD on June 11, 2015 — Written by Brian Krans

No. No, you should not. That’s the short answer.

“The real question is, why would you use statins while pregnant at all?” Dr. Stuart Spitalnic of Newport Hospital in Rhode Island asks. “Remember, cholesterol is not a disease, it is a risk factor for disease.”

Statins are a class of drugs that lower LDL, or “bad,” cholesterol levels in the body by preventing production in the liver, where the majority of the body’s cholesterol is produced.

The U.S. Food and Drug Administration (FDA) says that statins are not recommended for pregnant women. They are rated as “Pregnancy Category X” drugs, which signifies that studies have shown they may cause birth defects and that the risks clearly outweigh any benefit.

“There are some conflicting studies out there that statins can be safe during pregnancy, but since these studies are conflicting, it’s best to play it safe and stop the statins when trying to become pregnant and while pregnant,” notes Dr. Matthew Brennecke of the Rocky Mountain Wellness Clinic in Fort Collins, Colorado.

Dr. Brian Iriye of the High Risk Pregnancy Center in Las Vegas says that statins cross the placenta and have been associated with possible effects on the developing embryo.

“Inadvertent short-term exposure is unlikely to cause an increase in abnormal pregnancy outcomes,” he said. “However, due to the theoretical risk and limited benefits of these medications in pregnancy, most authorities recommend stopping this class of medication during pregnancy.” So, if your pregnancy was unplanned, like 50 percent of pregnant women, you and your baby should be fine; just stop the statin as soon as possible.

When You’re Pregnant, Cholesterol Rises Naturally

Expecting mothers experience a natural rise in their cholesterol levels. While this may appear alarming, it shouldn’t be. The levels typically return to normal six weeks after giving birth.

Most women will have a total cholesterol level around 170 before pregnancy. This will fluctuate between 175 and 200 during early pregnancy, and go up to about 250 in late pregnancy, Sharma says.

According to Harvard Medical School, a total cholesterol level below 200 is ideal and anything above 240 is considered high. However, these levels are not accurate for pregnancy.

Pregnant women experience a rise in LDL cholesterol, but their HDL (or “good” cholesterol, which helps dispose of bad cholesterol) cholesterol also rises to upwards of 65 during late pregnancy. HDL cholesterol above 60 protects against heart disease.

“Cholesterol actually is a key chemical required for pregnancy, as a baby utilizes cholesterol for brain development,” Iriye said. “Additionally, appropriate levels of cholesterol are needed during your pregnancy to produce estrogen and progesterone, which are key hormones for pregnancy and development.”

When Should You Worry About Cholesterol?

One thing to take into consideration is the mother’s health before the cholesterol levels begin to rise. Women aren’t typically at risk for cardiovascular disease until after menopause, when they’re no longer able to bear children.

“Considering that nearly all women of childbearing age are at nearly no risk, and won't be for years to come, not taking statins during pregnancy seems to be the only prudent answer,” Spitalnic says. “What medicine needs to do is stop promoting continuous risk factor paranoia. A pregnant women with elevated cholesterol should be comfortable not taking statins while pregnant.”

Diet and Exercise Before Medication

According to most medical guidelines, reducing your intake of saturated fats over a six-month period should be your first course of action.

“In some women, diet and lifestyle recommendations are enough,” says Sharma. “Both before and after pregnancy, take care of one's own health, with a heart-healthy diet and exercise habits.”

Brennecke agrees that eating a healthy diet is the first and foremost thing a pregnant woman can do to keep her cholesterol levels down. This includes eating foods that are low in saturated fat and high in fiber, including fruits and vegetables and whole, unprocessed grains.

“We all know women will sometimes get cravings during pregnancy, and in these cases, those women often feel like they have a free pass to eat whatever they want,” he says. “But eating a junky diet will mean that your baby will get those same nutrients, or lack thereof.”

Expecting moms also need to get in some exercise to help manage cholesterol levels.

“It doesn’t have to be rigorous exercise, just get out and move,” Brennecke says. “So, all you pregnant ladies or ladies looking to become pregnant, help keep your cholesterol in check by eating good foods and exercising. And stop taking that statin now! Your body and your baby will thank you for it.”

Medically reviewed by Steven Kim, MD on June 11, 2015 — Written by Brian Krans